Hubungan Polimorfisme Toll-Like Receptor 2 Dan Sifilis Okular
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Ni Made Dwi Puspawati
I Gusti Ayu Agung Elis Indira
Aditya Permana
Abstract
Sejak pandemi HIV terjadi peningkatan kasus sifilis okular. Hal ini perlu menjadi perhatian karena penyakit ini terutama dijumpai pada kelompok usia produktif, adanya risiko penyulit berupa gangguan penglihatan bahkan kebutaan, dan yang terpenting sampai saat ini pengobatan lini pertama untuk sifilis okular belum tersedia di Indonesia. Untuk itu sangat penting mengetahui faktor risiko yang mempengaruhi kejadian tersebut. Sifat genetik juga dapat berperan penting sebagai faktor risiko sifilis okular. Beberapa polimorfisme gen diperkirakan menjadi faktor risiko endogen terjadinya sifilis okular salah satunya adalah polimorfisme Toll-like receptor 2 (TLR2). TLR memegang peranan kunci dalam garis pertahanan pertama melawan patogen karena kemampuannya untuk mengenali pathogen-associated molecular patterns (PAMP). Saat ini telah diidentifikasi 10 TLR pada manusia yaitu TLR1 sampai TLR10. Beberapa TLR sangat spesifik dalam mengenali dan mengikat beberapa ligan tertentu, seperti TLR2 yang secara spesifik mengenali dan berikatan dengan lipoprotein bakteri. Treponema pallidum, adalah agen penyebab sifilis yang membran luarnya berupa lipoprotein sebagai penentu virulensi. Saat T. pallidum masuk kedalam tubuh host maka akan mengekspresikan banyak lipoprotein, kemudian merangsang sel imun bawaan melalui TLR2. Sehingga polimorfisme pada TLR2 diduga dapat merusak respon imun bawaan terhadap lipopeptida dan lipoprotein spirochetal. Suatu penelitian mendapatkan polimorfisme pada gen TLR2 berhubungan dengan penurunan respons terhadap stimulasi lipoprotein T47L dari T. pallidum dan secara signifikan berhubungan dengan neurosifilis dan sifilis okular. Perlu dilakukan penelitian lebih lanjut untuk mengetahui pengaruh polimorfisme TLR 2 sebagai faktor risiko kejadian sifilis okular.
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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
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